摘要
目的 使用高分辨磁共振血管壁成像(HRMR-VWI)评估未破裂颅内小动脉瘤(直径＜7 mm)的瘤壁特点.方法 回顾性分析2019年6月至2023年9月首都医科大学附属北京友谊医院诊断的未破裂颅内小动脉瘤患者病例资料.共25例患者共计33处小动脉瘤纳入分析.评估动脉瘤位置、动脉瘤壁是否强化、瘤壁有无局部变薄,并测量动脉瘤的大小、瘤壁厚度等.并比较微小动脉瘤组(直径＜3 mm)和小动脉瘤组(直径3～7 mm)上述特点的差异.结果 25例33处小动脉瘤,动脉瘤大小平均(3.3±1.5)mm,其中直径＜3 mm和直径3～7 mm组分别为17处和16处,最大动脉瘤壁厚度为(0.9±0.3)mm.19处(57.6％)动脉瘤壁可见强化,9处(27.3％)可见动脉瘤壁局部变薄.根据动脉瘤直径分为微小动脉瘤组(n=17)和小动脉瘤组(n=16).两组的动脉瘤位于前循环占比、动脉瘤位置分布、瘤壁强化程度、最大瘤壁厚度、局部动脉瘤壁变薄占比、腔内血栓占比比较,差异均无统计学意义(P＞0.05);微小动脉瘤的动脉瘤直径、瘤壁强化占比分别为(2.2±0.5)mm、35.3％,均低于小动脉瘤组[(4.4±1.4)mm、81.3％],差异均有统计学意义(P＜0.05).结论 HRMR-VWI图像有助于全面评估颅内小动脉瘤壁及瘤腔的特点.超1/2的小动脉瘤可见瘤壁强化,且微小动脉瘤的瘤壁强化比例更低,超1/4小动脉瘤可见局部瘤壁变薄.
Abstract
Objective To evaluate the characteristics of unruptured intracranial small aneurysms wall evaluated by high resolution MR vessel wall imaging(HRMR-VWI).Methods Retrospective analysis of HRMR-VWI database cases of intracranial small aneurysms diagnosed at Beijing Friendship Hospital,Capital Medical University from June 2019 to September 2023.A total of 25 patients with 33 small aneurysms were included in the analysis.The location of aneurysm,presence or not of aneurysmal wall enhancement,wall thinning,and intra-aneurysmal throm-bosis were assessed.Diameter and maximal wall thickness were measured.And the differences in the above characteristics were compared between the small aneurysm group(diameter＜3 mm)and the small aneurysm group(diameter 3-7 mm).Results There were 33 small aneurysms in 25 cases,with the average aneurysm size of(3.3±1.5)mm.Among them,there were 17 and 16 aneurysms in the diameter＜3 mm and 3-7 mm groups,respectively.The maximum aneurysm wall thickness was(0.9±0.3)mm.Presence of aneurysmal wall enhancement was found in 19 an-eurysms(57.6％),and local thinning of the aneurysm wall was found in 9 aneurysms(27.3％).According to the diameter of the aneurysm,it was divided into the small aneurysm group(n=17)and the small aneurysm group(n=16).There were no statistically significant differences in the proportion of aneurysms located in the anterior circulation,distribution of aneurysm locations,degree of wall enhancement,maximum wall thickness,proportion of local aneurysm wall thinning,and proportion of intracavitary thrombosis between the two groups(P＞0.05);the diame-ter of small aneurysms and the proportion of wall enhancement were(2.2±0.5)mm and 35.3％,respectively,which were lower than those in the small aneurysm group[(4.4±1.4)mm and 81.3％],and the differences were statistically significant(P＜0.05).Conclusion HRMR-VWI help to globally evaluate the features of the wall and lumen of intracranial small aneurysms.More than half of the small aneurysms show wall en-hancement,and the proportion of wall enhancement in＜3 mm group is lower.Wall thinning was found in about 1/4 of the small aneurysms.
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